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Publications

Journal Article Preprint Epublish

PubMed: 40630514 DOI: 10.21203/rs.3.rs-6945998/v1

Vaccine Effectiveness Among 5- to 17-year-old Individuals with Prior SARS-CoV-2 Infection: An EHR-Based Target Trial Emulation Study from the RECOVER Project.

Res Sq

Authors: Yong Chen, Yuqing Lei, Jiajie Chen, Qiong Wu, Ting Zhou, Bingyu Zhang, Michael Becich, Yuriy Bisyuk, Saul Blecker, Elizabeth Chrischilles, Dimitri Christakis, Lindsay Cowell, Mollie Cummins, Soledad Fernandez, Daniel Fort, Sandy Gonzalez, Sharon Herring, Benjamin Horne, Carol Horowitz, Mei Liu, Susan Kim, Parsa Mirhaji, Abu Mosa, Jennifer Muszynski, Catharine Paules, Alice Sato, Hayden Schwenk, Soumitra Sengupta, Srinivasan Suresh, Bradley Taylor, David Williams, Yongqun He, Jeffrey Morris, Ravi Jhaveri, Christopher Forrest

Affiliations

  • Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania.
  • University of Pennsylvania.
  • University of Pittsburgh.
  • University of Pittsburgh School of Medicine.
  • University Medical Center New Orleans.
  • Department of Population Health, New York University Grossman School of Medicine.
  • Department of Epidemiology, College of Public Health, The University of Iowa.
  • Center for Child Health, Behavior and Development, Seattle Children's Research Institute.
  • UT Southwestern Medical Center.
  • University of Utah.
  • The Ohio State University.
  • Ochsner Health.
  • Nicklaus Children's Hospital, Miami, FL.
  • Program for Maternal Health Equity, Center for Urban Bioethics, Department of Population Health and Urban Bioethics, Center for Obesity Research and Education, College of Public Health, Lewis Katz S.
  • Intermountain Medical Center Heart Institute.
  • Icahn School of Medicine at Mount Sinai.
  • University of Florida.
  • University of California, San Francisco.
  • Albert Einstein College of Medicine.
  • University of Alabama at Birmingham.
  • Nationwide Children's Hospital.
  • Division of Infectious Diseases, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA.
  • 982162 Nebraska Medical Center, Omaha, NE 68198.
  • Stanford School of Medicine.
  • Columbia University.
  • Medical College of Wisconsin.
  • University of Michigan Medical School.
  • University of Michigan.
  • Ann & Robert H. Lurie Children's Hospital of Chicago.
  • Children's Hospital of Philadelphia.

Abstract

The effectiveness of COVID-19 vaccination in children and adolescents with prior SARS-CoV-2 infection remains unclear, particularly for Omicron subvariants. We evaluated vaccine effectiveness against reinfection with Omicron BA.1/2, BA.4/5, XBB, and later subvariants among 5- to 17-year-olds using data from the RECOVER initiative, a national electronic health record database covering 37 U.S. pediatric institutions. We emulated target trials by age group and variant period, comparing previously infected participants between January 2022 and August 2023. During the BA.1/2 period, vaccination reduced the risk of reinfection, with effectiveness rates of 62% in children and 65% in adolescents. During the BA.4/5 period, protection effectiveness in children was 57%, whereas no statistically significant protection was observed in adolescents. During the XBB or later period, no significant protection was observed in either group. In summary, COVID-19 vaccination provided protection against reinfection during early and mid-Omicron periods in previously infected pediatric populations, but effectiveness declined for later variants.

MeSH

Sars-Cov-2, Vaccines, Vaccination, Adolescent, Covid-19, Severe Acute Respiratory Syndrome-Related Coronavirus, Reinfection, Infections, Child